ortho1991
Guru
I need help with is op-note. Our Physician does a combination of these two to three codes a lot and I could use some clarification on how to code these. I have tried to match what he is doing arthroscopically to open codes, but not sure if I can use 2 or 3 differant unlisted codes 29999 on the same claim, when you look at the open procedures you would bill out all seperate lines.
Thank you for any advice or guidance you can give. Here is the op-note.
Right hip diagnostic arthroscopy, trochanteric bursectomy, abductor tendon
repair and IT band lengthening. With the hip in the Smith and Nephew
traction table and abducted under fluoroscopic imaging a guidewire
technique was used to enter the trochanteric space. Under direct
visualization a mid-anterior portal was then established also using a
guidewire technique. An extensive amount of bursitis was noted. Using an
arthroscopic shaver and a radiofrequency ablation device, a trochanteric
bursectomy was performed. I performed a complete bursectomy taking out the
superior, posterior, inferior, distal, and proximal aspects of the bursa.
Once the bursa had been removed, the pectoralis tendon was visualized.
There was bruising and ecchymosis and full thickness tearing of the
abductor tendons. Using an arthroscopic shaver the footprint of the
abductor tendon was debrided until a good bleeding bony bed. A Mitek 4.5
mm peek triple loaded suture anchor was then placed in the center of the
footprint and using a 90 degree suture Lasso, the sutures were passed
through the abductor tendon in a horizontal mattress type fashion. Three
sets of 2 sutures were passed and excellent repair was obtained. We then
used those 6 sutures and then created a lateral row so that the abductor
tendon would really lay down. The lateral row we used a Arthrex 4.75
BioComposite swivel lock anchor. An excellent repair was obtained. The
abductor tendon laid down nicely over the footprint and a complete repair
was noted. Copious irrigation was performed. At the time of the
bursectomy I also lengthened the gluteus maximus tendon slightly just to
release some of the tension on the IT band and lengthening have in essence
performed an IT band lengthening. Having performed the abductor tendon
repair, trochanteric bursectomy and IT band lengthening we took the hip
through internal and external rotation and the tendon was in excellent
position. Copious irrigation was performed and all the arthroscopic
equipment was removed.
I see 3 unlisted codes IT band release. Trochanteric bursa excision. Abductor tendon repair. HELP
Thank you for any advice or guidance you can give. Here is the op-note.
Right hip diagnostic arthroscopy, trochanteric bursectomy, abductor tendon
repair and IT band lengthening. With the hip in the Smith and Nephew
traction table and abducted under fluoroscopic imaging a guidewire
technique was used to enter the trochanteric space. Under direct
visualization a mid-anterior portal was then established also using a
guidewire technique. An extensive amount of bursitis was noted. Using an
arthroscopic shaver and a radiofrequency ablation device, a trochanteric
bursectomy was performed. I performed a complete bursectomy taking out the
superior, posterior, inferior, distal, and proximal aspects of the bursa.
Once the bursa had been removed, the pectoralis tendon was visualized.
There was bruising and ecchymosis and full thickness tearing of the
abductor tendons. Using an arthroscopic shaver the footprint of the
abductor tendon was debrided until a good bleeding bony bed. A Mitek 4.5
mm peek triple loaded suture anchor was then placed in the center of the
footprint and using a 90 degree suture Lasso, the sutures were passed
through the abductor tendon in a horizontal mattress type fashion. Three
sets of 2 sutures were passed and excellent repair was obtained. We then
used those 6 sutures and then created a lateral row so that the abductor
tendon would really lay down. The lateral row we used a Arthrex 4.75
BioComposite swivel lock anchor. An excellent repair was obtained. The
abductor tendon laid down nicely over the footprint and a complete repair
was noted. Copious irrigation was performed. At the time of the
bursectomy I also lengthened the gluteus maximus tendon slightly just to
release some of the tension on the IT band and lengthening have in essence
performed an IT band lengthening. Having performed the abductor tendon
repair, trochanteric bursectomy and IT band lengthening we took the hip
through internal and external rotation and the tendon was in excellent
position. Copious irrigation was performed and all the arthroscopic
equipment was removed.
I see 3 unlisted codes IT band release. Trochanteric bursa excision. Abductor tendon repair. HELP